• Title/Summary/Keyword: Total elbow replacement

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Reconstructive Procedure of Elbow Joint -Semiconstrained Total Elbow Arthroplasty-

  • Lee Yong Geol
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 1995.05a
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    • pp.5-6
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    • 1995
  • ${\cdot}$ total elbow replacement arthroplasty incremental improvement. ${\cdot}$ semiconstrained device broadens the indications for joint replacement. ${\cdot}$ avoidance of complications is achieved by carefully planning and meticulous technique

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Intramedullary fibula strut bone allograft in a periprosthetic humeral shaft fracture with implant loosening after total elbow arthroplasty

  • Jo, Young-Hoon;Lee, Seung Gun;Kook, Incheol;Lee, Bong Gun
    • Clinics in Shoulder and Elbow
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    • v.23 no.3
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    • pp.152-155
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    • 2020
  • Periprosthetic fracture after total elbow replacement surgery is a difficult complication to manage, especially when it comes together with implant loosening. If stem revision and internal fixation of the periprosthetic fracture are performed simultaneously, this would be a very challenging procedure. Most of total elbow replacement implants are cemented type. Cement usage at periprosthetic fracture site may interfere healing of fractured site. Authors underwent internal fixation with use of locking plate and cerclage wire for periprosthetic fracture, allogenous fibular strut bone inserted into the humerus intramedullary canal allowing the fractured site to be more stable without cement usage. At 10-month follow-up, the complete union and good clinical outcome was achieved. We present a novel technique for treating periprosthetic fracture with implant loosening after total elbow replacement surgery, using intramedullary allogenous fibula strut bone graft.

Total elbow arthroplasty for posttraumatic destroyed or unreduced elbow joint (외상 후 파괴된 주관절 또는 진구성 탈구에서의 주관절 전치환술)

  • Kim, Young-Kyu;Jung, Lee-Hyuk
    • Clinics in Shoulder and Elbow
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    • v.6 no.1
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    • pp.37-43
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    • 2003
  • Purpose: To evaluate the results in patients who received total elbow replacement for posttraumatic destroyed or unreduced elbow joint. Materials and Methods: Six patients with posttraumatic destroyed, or unreduced elbow joint, who were nearly impossible to move actively and had pain and grossly unstable joint, were followed up average 42 months. 3 cases were soft tissue injuries and bone defects which were caused by severe comminuted fracture, 1 was a nonunion with comminuted fracture, and 2 were unreduced elbow joint. Total elbow replacement was performed average 10 months after the injury. All the cases were used by semiconstrained prosthesis, and the results were estimated by Mayo elbow perfomance score. Results: Pain was decreased in all the cases postoperatively. Average ranges of motion were improved with active extension 20° and flexion 120°. Mayo elbow performance scores were pain 42.5 points, range of motion 17.5 points, stability 8.3 points, function 19.2 points and totally 87.5 points, and final results were 3 excellent and 3 good. Loosening of prosthesis was not found in all the cases by final follow-up radiograph. Conclusicon: Semiconstrained TER can be used as a effective treatment improving pain and active ranges of motion caused by posttraumatic destroyed or unreduced elbow joint, however, long term follow-up is needed because early loosening of TER can be occurred due to severe bone defects.

'The design concepts of Kudo Total Elbow Prosthesis, and some of the technical considerations for its use'

  • Kudo Hiroshi
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2002.10a
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    • pp.177-179
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    • 2002
  • Total elbow prostheses which are now available in clinical use can generally be classified into two major categories ; one bing linked prostheses, another being unlinked prostheses. Of those two categories I am dealing here only with the problems of the unlinked type prosthesis, particularly with those of non-constrained, surface-replacement prostheses. Furthermore, my presentations this time may have to be narrowed down only to the topics regrading the particular features and some of the technical problems with Kudo Elbow Prosthesis, due to the time limit assigned for this presentation.

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Primary Total Elbow Replacement for Treatment of Complex Distal Humerus Fracture: Outcomes of Short-term Follow-up

  • Kim, Du-Han;Kim, Beom-Soo;Baek, Chung-Sin;Cho, Chul-Hyun
    • Clinics in Shoulder and Elbow
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    • v.23 no.1
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    • pp.20-26
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    • 2020
  • Background: High complication rate after open reduction and internal fixation can lead to use of primary total elbow replacement (TER) in treatment of complex distal humerus fractures in elderly patients. The purpose of this study was to investigate the short-term outcomes and complications after primary TER in patients with complex distal humerus fracture. Methods: Nine patients with acute complex distal humerus fracture were treated by primary TER using the semiconstrained Coonrad-Morrey prosthesis. The mean age of patients was 72.7 years (range, 63-85 years). Clinical and radiographic outcomes were evaluated over a mean follow-up of 29.0 months (range, 12-65 months) using visual analog scale (VAS) score for pain; Mayo elbow performance score (MEPS); Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, mean VAS, MEPS, and Quick-DASH scores were 1.2, 80.5, and 20, respectively. The mean range of motion was 127.7° of flexion, 13.8° of extension, 73.3° of pronation, and 74.4° of supination. There was no evidence of bushing wear or high-grade implant loosening on serial plain radiographs. Three complications (33.3%) comprising two periprosthetic fractures and one ulnar neuropathy were observed. Conclusions: Primary TER for treatment of complex distal humerus fractures in elderly patients yielded satisfactory short-term outcomes. However, surgeons should consider the high complication rate after primary TER.

Reverse Total Shoulder Replacement for an Enchondroma with Concomitant Rotator Cuff Tear Arthropathy: A Case Report

  • Park, Bong-Ju;An, Ki-Yong;Choi, Yong-Suk
    • Clinics in Shoulder and Elbow
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    • v.20 no.2
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    • pp.100-104
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    • 2017
  • Enchondromas generally occur in the hand and uncommonly in the long bones. Because enchondromas are usually asymptomatic, most are discovered during diagnostic radiology for another disease. Here, we describe a case of enchondroma in the right humerus in a 79-year-old female patient with concomitant rotator cuff tear arthropathy. The patient was initially hospitalized for prolonged pain and pseudoparalysis of the right shoulder. The condition, which was histologically confirmed as an enchondroma in the proximal humerus, was treated with curettage and reverse total shoulder arthroplasty. In this case report, we present a rare case of an enchondroma with combined rotator cuff tear arthropathy.

Subscapular and Pectoralis Major Sparing Deltopectoral Approach for Reverse Total Shoulder Arthroplasty

  • Chung, Young-Woo;Seo, Jae-Woong;An, Ki-Yong
    • Clinics in Shoulder and Elbow
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    • v.22 no.2
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    • pp.110-112
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    • 2019
  • In reverse ball shoulder replacement, surgery is usually performed using a deltopectoral approach or an anterosuperior transdeltoid approach. The deltopectoral approach is to incise the pectoralis major to upper 1/3 to 1/2, and subscapularis tendon should be removed at the lesser tuberosity of the humerus. This approach has the problem of breaking the shoulder deltoid instead of incising the rotator cuff. Therefore, we report a detailed procedure of reverse ball shoulder replacement using approach without incision of the pectoralis major muscle and subscapularis muscle.

The Open Surgical Treatment for Stiff Elbow (주관절 구축의 관혈적 치료)

  • Lee, Ji-Ho;Ra, In-Hoo;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.293-298
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    • 2010
  • Purpose: Since an injured elbow joint can disturb the activity of daily life by limiting motion, especially if the motion is restricted over 40 degree of flexion contracture and under 105 degree of further flexion, it is imperative to select the best method and the timing of treatment of the elbow stiffness. Therefore this review will discuss open surgical techniques for stiff elbows based on the literature. Materials and Methods: It is important to take sufficient clinical examination of the patient, including history taking. And, a surgeon should select appropriate procedure after accurately understanding about the status and cause of the stiff elbow with radiographic methods. Surgical methods include arthroscopic release open release, distraction arthroplasty, total elbow replacement and there are four approachs in the open release - anterior approach, medial "over the top" approach, limited lateral approach: column procedure, posterior extensile approach-. Results and Conclusion: Although at present the arthroscopic technique is emphasized for the treatment of elbow stiffness, a surgeon should know conventional open techniques.

Comparison of open reduction and internal fixation with total elbow arthroplasty for intra-articular distal humeral fractures in older age: a retrospective study

  • Baik, Jong Seok;Lee, Sung Hyun;Kang, Hyun Tak;Song, Tae Hyun;Kim, Jeong Woo
    • Clinics in Shoulder and Elbow
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    • v.23 no.2
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    • pp.94-99
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    • 2020
  • Background: Intra-articular distal humeral fractures can be surgically challenging. It remains under discussion whether open reduction and internal fixation (ORIF) or total elbow arthroplasty (TEA) is more beneficial for treatment of the elderly. This study aimed to compare the clinical and functional outcomes of ORIF and TEA for managing intra-articular distal humerus fractures in patients aged 65 years or older. Methods: Patients who underwent ORIF (n=28) or TEA (n=43) for in intra-articular distal humerus fracture between May 2008 and December 2018 were reviewed. Range of motion, Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiologic outcomes, and surgical complications were evaluated at the final follow-up visit. Results: The ORIF and TEA groups showed a mean arc of flexion-extension of 97°±21° and 101°±12°, respectively. The mean MEPS and DASH scores were 94±15 and 27±12 points, respectively, in the ORIF group and 81±27 and 47±28 points in the TEA group. This difference was statistically significant. The incidence of total complications was similar between the groups. Conclusions: In patients older than 65 years with intra-articular distal humerus fracture, ORIF had better outcomes than TEA.